06 November 2024

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Prosthodontic Rehabilitation of a Bruxer Patient with Severely Worn Dentition: A Clinical Case Report

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The management of tooth wear has been a subject of increasing interest from both preventive and restorative points of view. This article describes the full mouth rehabilitation of a 54-year-old bruxer woman with a severely worn dentition and other dental problems including unsuitable restorations and several missing teeth. The treatment entailed using cast posts and cores, metal-ceramic restorations, and a removable partial denture. As with the treatment procedure of such cases, equal-intensity centric occlusal contacts on all teeth and an anterior guidance in harmony with functional jaw movements were especially taken into account.

Introduction

Severe tooth wear is a potential threat for dentition and masticatory function. Many factors may combine to produce the worn dentition and the etiology often remains unidentified.1 Tooth wear has been classified into the following four types: (1) attrition, that is the wear of teeth or restorations caused by tooth to tooth contact during mastication or parafunction; (2) abrasion, that is the loss of tooth surface caused by abrasion with foreign substances other than tooth to tooth contact; (3) erosion, that is the loss of tooth surface by chemical processes not involving bacterial action; and (4) abfraction, that is non-carious cervical wedge-shaped defect caused by occlusal stresses.2-4 The management of tooth wear, especially attrition, is becoming a subject of increasing interest in the prosthodontics literature, from both preventive and restorative points of view.5 A critical aspect for successful treatment is to determine the occlusal vertical dimension (OVD) and the inter-occlusal rest space (IRS). A systematic approach for managing tooth wear can lead to a predictable and favorable prognosis.6

This article presents the stages of prosthodontic rehabilitation, from diagnosis to final treatment and follow-up, of a bruxer patient with severely worn dentition, some extracted teeth and uneven occlusal plane, using cast posts and cores, metal-ceramic restorations, mandibular removable partial denture (RPD) and an occlusal splint for protecting the restorations from patient’s parafunction.

Authors: Farhang Mahboub, Elnaz Moslehi Fard, Farideh Geramipanah, Habib Hajimiragha

Source: https://pmc.ncbi.nlm.nih.gov/